timing protein with Sinemet CR 50-200

Hello. When my mother took Sinemet 25/100 we tried to ensure the dose was separated from protein intake by at least 30 minutes. About 7 months ago she switched to Sinemet CR 50/200, 4 times a day. Should she still be separating the dose from protein, or does it make a difference since this is an extended release pill? It would be much easier if she could take the medication right before meals, but of course we want the medication to work the most effectively. Thank you for any input you can share.

First of all, I would like to say, " Thank You," from all of us with PD for being such an involved caregiver. I always tell people that it is much easier to have PD than it is to take care of a person with PD. An involved caregiver can increase the quality of life of a person with PD so much. Thank you again, from all of us.Ok, now to the subject at hand. Yes, mqintain the same rules with the Sinemet CR as you did with the regular Sinemet. Think of ot this way, the CR may last longer, but the time it takes to START working is about the same as the regular. I usually go with anywhere from 30 to 60 minutes because some people metabolise easier than others. Another saying I use is, "When the med starts to worky, it's time to bite of jerky." This ryme came from me trying to explain to my youngest daughter why I need to wait to eat sometimes after I take my medicine. So, I will give her all the credit.Thanks again for doing what you do.

Hello. When my mother took Sinemet 25/100 we tried to ensure the dose was separated from protein intake by at least 30 minutes. About 7 months ago she switched to Sinemet CR 50/200, 4 times a day. Should she still be separating the dose from protein, or does it make a difference since this is an extended release pill? It would be much easier if she could take the medication right before meals, but of course we want the medication to work the most effectively. Thank you for any input you can share.

Thank you for your response - and for sharing your family poem with us! It helps to add a light touch to the rest of this business.

I have a follow-up question if you don't mind. I'm trying to understand why the Sinemet CR is only inhibited by protein ingested earlier in the cycle that it's in someone's system. If medicine is continuing to be released wouldn't any protein keep it from working effectively? Is it that the medicine is further down the system, and the protein doesn't catch up to it? If you don't have time to answer this that's ok, it's more curiosity at this point - we'll still hold the jerky till it's workee-ng.

Thank you so much for sharing your knowledge, and helping us make more sense of all that's going on. You really make a difference.

The reason is that the medicine is already moved through the intestine and is being metabolized slowly in the liver by an enzyme system. Now, anything taken after the sinemet has to wait for the sinemet to be metabolized.
The sinemet starts working after it has begun to be metabolized by the liver. That is when you "feel it." Then, if you eat something at the time you "feel it," it has to be broken down in the stomach, move to the intestine, be absorbed through the intestine, then move to the liver to be metabolized into the nutrients the body needs. If sinemet is already there, it has to wait. If it gets there before sinemet, then sinemet has to wait.
Hope that helps.

It's a little hard to believe that a small pill that is dissolved in the instestine could interfere with food from being absorbed just because it got there first and vice versa? How does our intestine know the difference? Is there like a gate keeper that holds one or the other at bay? I am confused. I assumed everything gets absorbed once it goes down your stomach.... at the same time.

It is the liver. I guess the best example would be a funnel. You can only pour so much in, then you have to wait for it to drain before you give any more. The body has amzing processes to control itself, this would be one of them.
Please keep me updated if you need anything else.

Based on your own experience since your eating schedule is centered around when you take your meds do you eat at werid times like 9am for breakfast and 3pm for lunch, etc? I am trying to time it for my mom for the evening dose since she seems to be very woosy and talk and make moaning noises and grind her teeth in bed after she takes her dose at 8:30pm. We finish dinner around 7:30 at the latest. Sometimes I might give her a sugery treat after dinner that may have some protein so that could affect her?

When she takes her meds at 6:00am she's perfectly fine. I can only speculate it is because she does this on an empty stomach at that time. The teeth grinding only occurs in the late afternoon and evening and rarely in the mornings.

Truthfully, I eat small amounts of food throughout the day. Maybe every few hours I will eat something: an apple, nutrition bar, apple sauce, carrots and dip, etc.. and only eat protein when I do not have a dose of sinemet that just passed or is coming up shortly.